This rotation provides opportunities in 1) comprehensive health care industry occupational health programs and 2) academic occupational and environmental clinics. This comprehensive, multidisciplinary rotation provides experience with clinical evaluations, including fitness for duty and medical surveillance; injury care; workers' compensation and disability management and hazard recognition and evaluation. Residents work with industrial hygienists and safety specialists in field settings to address biosafety, radiation safety, ergonomics, and chemical hazards. The rotation significantly expands the clinical experience of the residents, contact with core faculty, and exposure to more complex occupational and environmental medicine cases (as well as more specialized occupational medicine functions such as independent medical evaluation and medical review officer).

Residents meet with Dr. Edward Bernacki in the Johns Hopkins University’sDepartment of Health, Safety & Environment, where they focus on management and administrative issues such as how to set up medical surveillance, wellness/health promotion, and workers’ compensation programs. Residents rotate in the Occupational Injury Clinic at JHH with Dr. Robert Lavin managing acute and chronic employee injuries and musculoskeletal disease. The clinical component at Johns Hopkins is combined with industrial hygiene, ergonomics, and safety through the Environmental Health and Safety Office of Johns Hopkins Hospital where residents also learn radiation protection, biosafety, and other elements of the comprehensive Johns Hopkins health and safety program. Assessment of workplace hazards in the worksite is an important element of this rotation. Residents rotate with Dr. Melissa Frisch, at the University of Maryland Medical Center, addressing programmatic issues as well as performing medical surveillance, fitness for duty, and return to work exams and evaluating and treating occupational injuries.

Residents participate in academic occupational and environmental medicine clinics. These include 1) the JHU Center for Occupational and Environmental Health where they see complex occupational medicine cases, independent medical examinations, workers’ compensation cases, and environmental exposures and diseases with Drs. Virginia Weaver and Brian Schwartz; 2) theOccupational Health Program Clinicof the University of Maryland where residents gain experience in medical surveillance and complex occupational medicine consults with Drs. Melissa McDiarmid and Stella Hines; and 3) theCenter for Occupational and Environmental Neurology, where trainees gain experience in the diagnosis and treatment of neurologic disorders related to neurotoxic exposures and ergonomic stressors (repetitive strain injuries) through work with Dr. Margit Bleecker.

In addition, residents have the opportunity in this rotation to spend time with Dr. Schwartz in New Mexico on the Los Alamos Former Workers Program. This project, which evaluates former LANL workers for occupational diseases due to past exposure to beryllium, noise, lead, asbestos, hydrocarbon solvents, and ionizing radiation, has examined over 2,900 former workers to date. Residents examine 8 to 10 former workers daily, assessing past exposure to the agents previously mentioned, and participate in decisions about follow-up diagnostic testing, treatment recommendations, and work-relatedness determinations.